How Well Does Subjective Cognitive Decline Correspond to Objectively Measured Cognitive Decline? Assessment of 10–12 Year Change

Article type: Research Article

Authors: Gustavson, Daniel E.^{a; b; *} | Jak, Amy J.^{c; d} | Elman, Jeremy A.^{c; e} | Panizzon, Matthew S.^{c; e} | Franz, Carol E.^{c; e} | Gifford, Katherine A.^b | Reynolds, Chandra A.^f | Toomey, Rosemary^g | Lyons, Michael J.^g | Kremen, William S.^{c; e; h}

Affiliations: [a] Department of Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA | [b] Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA | [c] Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA | [d] Psychology Service, Veterans Affairs San Diego Healthcare System, La Jolla, CA, USA | [e] Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA | [f] Department of Psychology, University of California, Riverside, Riverside, CA, USA | [g] Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA | [h] Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System, La Jolla, CA, USA

Correspondence: [*] Correspondence to: Daniel E. Gustavson, Department of Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, 2215 Garland Ave, 511H Light Hall, Nashville, TN, 37232, USA. Tel.: +1 615 936 2660; E-mail: daniel.e.gustavson@vumc.org.

Abstract: Background:Although not strongly correlated with current objective cognitive ability, subjective cognitive decline (SCD) is a risk factor for Alzheimer’s disease. Most studies focus on SCD in relation to future decline rather than objective prior decline that it purportedly measures. Objective:We evaluated whether self-report of cognitive decline—as a continuous measure—corresponds to objectively-assessed episodic memory and executive function decline across the same period. Methods:1,170 men completed the Everyday Cognition Questionnaire (ECog) at mean age 68 assessing subjective changes in cognitive ability relative to 10 years prior. A subset had mild cognitive impairment (MCI), but MCI was diagnosed without regard to subjective decline. Participants completed up to 3 objective assessments of memory and executive function (M = 56, 62, and 68 years). Informant-reported ECogs were completed for 1,045 individuals. Analyses controlled for depression and anxiety symptoms assessed at mean age 68. Results:Participant-reported ECog scores were modestly associated with objective decline for memory (β= –0.23, 95%CI [–0.37, –0.10]) and executive function (β= –0.19, 95%CI [–0.33, –0.05]) over the same time period. However, these associations were nonsignificant after excluding MCI cases. Results were similar for informant ratings. Participant-rated ECog scores were more strongly associated with concurrent depression and anxiety symptoms, (β= 0.44, 95%CI [0.36, 0.53]). Conclusion:Continuous SCD scores are correlated with prior objective cognitive changes in non-demented individuals, though this association appears driven by individuals with current MCI. However, participants’ current depression and anxiety ratings tend to be strongly associated with their SCD ratings. Thus, what primarily drives SCD ratings remains unclear.

Keywords: Aging, cognitive decline, cognitive function, executive function, latent growth model, memory

DOI: 10.3233/JAD-210123

Journal: Journal of Alzheimer's Disease, vol. 83, no. 1, pp. 291-304, 2021